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PUSAT HUBUNGAN DAN JARINGAN INDUSTRI CENTRE FOR fNDUSTR\1 RELATIONS AND NETlA'ORI Be a full-time undergraduate or graduate student at local universities approached by Hitachi Will remain as a full-time undergraduate or graduate student until completion of HYLI program in July 2017 Maintain a minimum CGPA / CAP / GPA of 3.0 out of 4 (or 3.5 out of 5) ~ Be active in extra-curricular activities and / or community work Have a keen interest in and be familiar with regional and global affairs v Have good written and spoken English, preferably with a flair for public speaking Commitment to attend post HYLI event in each country scheduled from October to December in 2017 Commitment to share the lessons learned in HYLI with as many peers as possible Thrive to spearhead realization of sustainable and inclusive society as a leader Graduates of past HYLI programs are not eligible to apply

Did you tick

£ill the

boxes?

Congratulations, you are eligible for consideration to be a representative of your country at the 14th HYLI!

1

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lnspire the Next: Important notes 1. The 14th Hitachi Young Leaders Initiative (HYLI) will be held from 10 to 13 July 2017 in Yangon, Myanmar. 2. The final selection interviews are planned to be conducted from February to March 2017. Short-listed students must be available to attend their final interview. 3. Students selected to participate in the 14th HYLI will be required to submit a paper on their research and understanding of their designated theme, prior to the event. 4. Students selected will be requested to present a performance during the 14th HYLI that is representative of their home country's culture. 5. Students selected will act as ambassadors of their respective countries and will be required to respect the guidelines set out by the organiser and participate in all activities throughout the 14th HYLI. 6. The organiser will sponsor event-related round trip airfare, hotel accommodation and meals of selected student representatives attending the 14th HYLI. 7. For information on past initiatives, please visit: http://www.hitachi.com.sg/aboutlhitachi/activities/hyli/index.html 8. Please note that late submissions or incomplete application forms will not be considered.

Please submit the completed forms to Sharon Kuan I Keng Mun of Jireh Consult at [email protected]

-End of Note-

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I-iITACHI Inspire the Next PARTICIPANT APPLICATION A.

FORM

PERSONAL PARTICULARS

Name

_

Nationality

_

Country of Birth Age

Attach Recent Colour Photo

_ Gender

_

Mailing Address ---------------------------------1

Home/Mobile Telephone Email

_

------------------------------

B. EDUCATIONAL INFORMATION Please attach photocopies of results for all university level examinations. Institution Currently Attending

_

Faculty

_

Subjects Majored in

_

Current Year of Study (e.q. First year, Second year)

_

Grade Point Average (GPA / CGPA / CAP)

_

Educational Background

Schools/Institutions

and Country Attended

Other Academic Qualifications

Highest Standard Passed

Year Passed

------

3

HITAGHI Insplre the Next C. COMMAND OF ENGLISH LANGUAGE TOEICfTOEFL score (if applicable)

_

Written (Please state level of proficiency: excellent, good, fair)

Spoken (Please state level of proficiency: excellent, good, fair)

D.

EXTRACURRICULAR

ACTIVITIES

a Societies/Clubs/Sports Name of Organization

Description of Involvement [e.g. level of participation(State if member or officer), prizes and awards where applicable)

Period of Membership

Person In Charge / Contact Details

b Pa rtiicrpa fIon In non-university't sponsore d vounq Iea ders proqram Name of Organization

Description of Program

Period of Participation

Person In Charge / Contact Details

c. Scholarships and Other Activities (e.g. Community and voluntary work, debates, essay/art competitions, scouts etc.)

d. Hobbiesllnterests

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HITACHI Inspire the Next

E.

ESSAY

Please answer the following questions: 1. Why do you want to join the Hitachi Young Leaders Initiative (HYLI)? What difference will HYLI make in helping you achieve your goals? (Please limit your response to 250 words)

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HITACHI

Inspire the Next F.

REFERENCE

Please obtain the signature from one university official as a referee who supports your participation in the initiative. Please note that relatives and friends should not be used as referees and the organizer may contact the referee(s) for a testimony if necessary.

Name

-----------------------------------------------------------

Occu pation Office/Mobile Relationship

Com pany/Organization Num ber

_

Email

_

to Applicant

I,

_

hereby

affirm

that the applicant

of this application

Name of Reference

form

fulfills

recommend

-.-

the

basic

the applicant's

qualifying

participation

-Reference's Name and Signature

Basic

criteria

to

apply

for

the

program

and

I

in the initiative.

Date

qualifying criteria (Please check the criteria the applicant

fulfills)

Be a full-time undergraduate or graduate student at local universities approached by Hitachi Will remain as a full-time undergraduate or graduate student until completion of HYLI program in July 2017 Maintain a minimum CGPA / CAP / GPA of 3.0 out of 4 (or 3.5 out of 5) Be active in extra-curricular activities and / or community work Have a keen interest in and be familiar with regional and global affairs Have good written and spoken Enqfish, preferably with a flair for public speaking Commitment to attend post HYLI event in each country scheduled from October to December in 2017 Commitment to share the lessons learned in HYLI with as many peers as possible Thrive to spearhead realization of sustainable and inclusive society as a leader Graduates of past HYLI programs are not eligible to apply

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HIIA\,;HI Inspire the Next G.

DECLARATION

A. I hereby affirm that the information provided in this application form is true and accurate to the best of my knowledge. B. I hereby agree and consent that Hitachi, Ltd. and Hitachi Asia Ltd. ("Companies") may collect, use, disclose and process my personal data which is provided by me in this application form or otherwise, for one or more of the purposes relating to the Companies' "14th Hitachi Young Leaders Initiative" ("Project"), which in summary includes but are not limited to the following: a. The screening of my application for the purpose of selection for this Project; b. In the event that I am offered to be a student delegate to the Project and have agreed to such offer, for the following purposes: i. Arrangement of meals, accommodation and transport for attendance to the Project including collection of passport information, medical conditions and dietary restrictions (where applicable); ii. Public disclosure of my name, university affiliation, and nationality to promote the Project. Public disclosure includes but is not limited to Companies website, news release, Project white paper and other print and online publications: iii. Public disclosure of my interview responses to media representatives attending the Project; and iv. Maintaining contact with the Companies as member of the exclusive Hitachi Young Leaders Initiative alumni network post-Project; c. The purposes stated in Hitachi Asia Privacy Terms and Conditions available at http://www.hitachi.com.sgJutilityJprivacyJindex.html. (collectively, the "Purposes") C. My personal data may/will be disclosed by Companies to its third party service providers or agents (including public relations agency(ies», which may be located within or outside of Singapore, for one or more of the Purposes and such third party service providers or agents, if engaged by Companies, would be processing my personal data for Companies for one or more of the Purposes. D. To the extent that Companies appoint any authorised public relations agency(ies) to collect, use, disclose and process my personal data for Companies for one or more of the Purposes, the consent given herein shall be extended to such collection, use, disclosure and processing of my personal data by Companies' authorised public relation agency(ies). I have read and agree to the above:

Applicant's Name and Signature

Date

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HITACHI Inspire the Next IHIlITACJH[I[ YCOJUNG ILlEAJIVlEN§ JINJI1rJIAJfJIVlE [JRIYILII]

PROGRAM 1Nl AKA DIJALA KAN DI YANGO , MYANMAR

PADA 10-13 JUlAI 2017 TUJUAN ~ROGRAMINIADALAH

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